Familial congenital glaucoma and epilepsy: a case series.

We present two siblings from consanguineous marriage, both with congenital glaucoma and seizure disorders with progressive visual impairment and blindness. The pedigree showed that five (one male and four females) of the eleven siblings have varied degrees of visual impairment to blindness with seizure disorders. To the best of our knowledge, familial congenital glaucoma with epilepsy has not been reported, hence the communication to highlight this unusual condition which could be an association or syndromic.Key words: Consanguinity, Familial, Congenital glaucoma, Epilepsy

Presentation, complications and management outcome of community acquired pneumonia in hospitalized children in Maiduguri, Nigeria

Background: Pneumonia remains a leading cause of U-5 morbidity and mortality in developing countries like Nigeria. This study was conducted to determine the clinical presentation, complications and factors contributing to mortality in the hospitalized children with community acquired pneumonia (CAP) in Maiduguri, Nigeria.Methods: Children younger than 14 years admitted into the EmergencyPaediatric Unit of the University of Maiduguri Teaching Hospital(UMTH), Maiduguri, in 2011 with the diagnosis of community acquiredpneumonia were followed up until discharge or death. Chest radiographswere read by radiologists.Results: Eighty nine children aged two months to 14 years were studied. The commonest clinical features were fever, cough, tachypnoea and dyspnoea. Radiographic evidence of pneumonia was found in 84 (94.4%) of cases. Dehydration and congestive cardiac failure (CCF) were the commonest complications encountered. Eight (9.0%) children died, seven of whom had complications of pneumonia. The rate of occurrence of complications, radiographic pattern of pneumonia and outcome of treatment did not significantly differ statistically in the different age groups; p = 0.135, 0.622 and 0.167 respectively.Conclusion: While dehydration and CCF were found to be commonestcomplications, mortality was commoner among the male infants hospitalized for pneumonia

Co-morbidities in children hospitalized for community acquired pneumonia in Maiduguri, Nigeria

Background: Pneumonia is one of the commonest causes of morbidity and mortality in children, especially in developing countries. These children are also at risk of other morbidities, thus, increasing the morbidity and mortality.Objective: This study was conducted to examine the prevalence and pattern of co-morbidities in children admitted for community acquired pneumonia (CAP) in Maiduguri.Methodology: All children admitted into the Emergency Paediatric Unit (EPU) of the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, in 2011, with CAP were prospectively followed until discharge or death. The children were evaluated for co-morbidities clinically and by examination of appropriate specimen where necessary.Result: A total of 115 children aged one month to 14 years were admitted for CAP during the study period. While majority of the children studied were underfive; 107 (93%), 65(56.5%) were males, 101 (87.8%) had one or multiple co morbidities, with about half of them 58 (50.4%) afflicted by malaria. Pre admission medication was commoner for orthodox than traditional medication. No significant difference in mortality outcome was however noticed between children with co-morbidity and those without comorbidity, p > 0.05.Conclusion: The occurrence of comorbid conditions among children hospitalized for CAP in Maiduguri is common; however, the presence of co-morbidity did not significantly affect the mortality outcome of their management. It is recommended that the presence of comorbidity be actively looked for in children hospitalized for pneumonia, so as to effect holistic treatment, and improve the outcome of management.Keywords: Pneumonia, Children. Co-morbidity, Maiduguri, Mortality outcom

Post-neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

Background: Tetanus is a public health problem in Nigeria. This study examines the demographic and clinical profile of postneonatal tetanus (PNT) seen in University of Maiduguri Teaching Hospital (UMTH), North- eastern Nigeria.Methods: This is a hospital-based prospective study of PNT. All childrenbeyond the neonatal period to 14 years of age admitted into the Paediatrics unit of UMTH, Maiduguri from June 2009 to July2011 with the diagnosis of PNT were studied.Results: A total of 39 cases of PNT were admitted over the period underreview. The male: female ratio was 2.3:1.0. Their ages at presentationranged between 16 months and 14 years, with mean +SD of 6.9+3.87 years. Over 90 percent of the children were either not immunizedagainst tetanus or their immunization status was unknown and onlytwo of the children were fully immunized. No booster immunizationwas received by any of the eligible children. The portal of entry of the infection was injury to the lower limbs and otogenic route in 53.9% and 33.3% respectively. Majority of patients were of low socioeconomicstatus. The duration of hospital stay ranged between 1-50 days with mean + SD (18.68+ 11.51).The mortality rate was (7)18 %.Conclusion: Tetanus still remains a major cause of childhood morbidityand mortality in Nigeria. Severe disease and the first one week of admission are the main variables identified to influence outcome.Therefore, there is need to strengthen routine immunization and booster doses of tetanus toxoid (TT) should be mandatory at primary and secondary school entry. Close monitoring of patients with severe tetanus during the critical period is imperative for successful management

Prevalence and burden of HBV co-infection among people living with HIV:A global systematic review and meta-analysis

Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 7.6% (IQR 5.6%-12.1%) in PLHIV, or 2.7 million HIV-HBsAg co-infections (IQR 2.0-4.2). The greatest burden (69% of cases; 1.9 million) is in sub-Saharan Africa. Globally, there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6%-7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%-16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in sub-Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth-dose. Findings also highlight the importance of targeting PLHIV, especially high-risk groups for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of antiretroviral therapy (ART) for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBV co-infection, and in pregnant women to also reduce mother-to-child transmission of HBV alongside HIV

Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Oral Candidiasis: A Tool For The Detection Of Presence And Progression Of Hiv Infection In Children In Maiduguri, Nigeria

Oral cavity is an important and frequently undervalued source of diagnostic and prognostic information in patients with Human Immunodeficiency virus (HIV) infection. This objectives of the study were to determine the prevalence of HIV infection in children using oral thrush as a marker of disease presence and to find out the relationship of CD4 count with oral candidiasis in HIV-infected children. The study group consisted of 108 children aged 18 months to 5 years presenting with oral thrush as seen in the paediatric units of the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria from July 2006 to June 2007. The diagnosis of HIV infection was made by double ELIZA technique and Dynal beads technique (Dynal Biotech, Oslo, Norway) for CD4 counting was used. Of the 108 children, 60 (55.5%) male and 48 (44.5%) were female with a male to female ratio of 1.25:1. Twenty children (18.5%) were found to be HIV sero-positive by double ELISA technique. Fifteen (75%) of positive children were less than 36 months, with 18 (90%) of the positive children coming from the lower socio-economic classes 4 and 5. Mother to child transmission (MTCT) was found to be responsible for 85% of infection in the present study (

Audit of childhood diarrhoeal management by health professionals in north eastern Nigeria

Diarrhoea is still an important cause of under-5 morbidity and mortality especially in developing countries, like Nigeria. Objective: The management practices of childhood diarrhoea by nurses and mid-wives in two health institutions in Northeastern Nigeria were assessed. Method: The study was conducted in the University of Maiduguri Teaching Hospital, Maiduguri and Federal Medical Centre Azare, Nigeria in June 2009 by administering closed ended self administered pre-tested questionnaire. Results: A total of 86 nurses/mid wives answered and returned the questionnaire. Of the 86 respondents, 66 were females, while the remaining 20 were males. According to the respondents, bacteria is the commonest cause of childhood diarrhoea followed by teething; 36(41.9%) and 18(20.9), respectively. Seventy seven (89.5%) of the respondents would use ORS first in the treatment childhood diarrhoea. While  12  (14.0%)  of the nurses/midwives identified up to three home fluids, apart from the "conventional"  ORS/SSS that can be used in the management of childhood diarrhoea, 22 (25.6%) respondents identified no other home fluids. Although, up to 54 (62.8%) of the respondents would increase thp feeding frequency of a child with diarrhoea, 17(19.8%) of them would stop feeding. At least one correct indication for referral and preventive measures of childhood diarrhoea was fielded by 50 (58.1%) and 73 (84.9%) of the respondents respectively. Conclusion: Although the management practices of childhood diarrhoea among the nurses and midwives was generally satisfactory, some gaps were identified. There is therefore the need for continued training of health workers in the management of common childhood illnesses

AIDS-Associated Non-Hodgkin Lymphoma in a Neglected Child: a Case Report.

Human immunodeficiency virus (HIV) infection is a global health, social and economic burden. The World Health Organization (WHO) recommended early antiretroviral (ART) treatment of all HIV infected infants/children, because the risks of progression to acquired immunodeficiency syndrome (AIDS) and risk of death is high and may be rapid. However, not many HIV infected children are accessing ART due to non-availability of paediatric drug formulations, under-diagnosis of the infection among others. Another important reason though not usually quoted is lack of proper counseling of the parents at the ART clinic. We present a case of perinatally HIV-infected girl, who died of multiple HIV complications due to late presentation despite the fact that her father was accessing HIV care and treatment.Key words: HIV/AIDS, Non-Hodgkins Lymphoma, Children, Complications, Nigeri

Study of Hepatic functions and prevalence of Hepatitis B surface Antigenaemia in Nigerian children with human immunodefiency virus infection

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